Glucagon is a hormone produced by the pancreas that raises blood sugar by signaling the liver to release stored glucose (glycogen). It functions in opposition to insulin and is an emergency treatment for severe low blood sugar, also known as hypoglycemia.
When to Administer Glucagon
Glucagon is typically administered during severe episodes of low blood sugar when an individual is unable to consume sugar orally. This often occurs if a person is unconscious, experiencing seizures, or unable to swallow safely. Symptoms indicating the need for emergency glucagon include confusion, disorientation, slurred speech, or a complete loss of consciousness. Glucagon is reserved for these emergencies, as milder low blood sugar can usually be corrected by consuming fast-acting carbohydrates.
How to Administer Glucagon
Administering glucagon involves specific steps, varying slightly depending on whether an injectable kit or a nasal spray device is used.
Injectable Glucagon Kit
For an injectable kit, remove the flip-off seal from the powdered glucagon vial. Remove the cap from the prefilled syringe containing sterile water. Inject the syringe’s entire contents into the powdered glucagon vial.
With the syringe still in the vial, gently swirl or shake until the powder dissolves and the solution is clear and colorless. Do not use if cloudy or contains particles. After dissolving, invert the vial and draw all liquid into the syringe. Tap out any air bubbles.
Choose an injection site like the outer thigh, upper arm, or buttocks. If available, clean the area with an alcohol swab. Pinch the skin, insert the needle into the muscle at a 90-degree angle, push the plunger completely, and withdraw the needle smoothly.
Nasal Glucagon
For nasal glucagon, remove the device from its packaging. Hold the device between your thumb and fingers, avoiding premature plunger activation. Gently insert the tip into one nostril until your fingers touch the outside of the nose.
Once positioned, firmly push the plunger all the way in until it stops, releasing the single dose. The medication absorbs through the nasal lining and works even with a cold; inhalation is not required. Each device contains one dose and is not reusable.
After Glucagon Administration
Immediately turn the person onto their side to prevent choking if vomiting occurs, a common side effect. Contact emergency medical services immediately.
Monitor the individual’s response. Most regain consciousness within 15 minutes. If no response after 15 minutes, a second dose may be given if available and instructed by a healthcare provider.
Once awake and able to swallow, provide a fast-acting sugar (e.g., fruit juice or glucose tablets). Follow with a longer-acting carbohydrate and protein snack (e.g., crackers and cheese) to prevent another drop. Inform the healthcare provider about the episode.
Important Considerations for Glucagon Use
Store glucagon kits properly to maintain effectiveness. Store at room temperature (68°F-77°F / 20°C-25°C) in original packaging, away from light. Check and replace kits before expiration. Use mixed injectable glucagon immediately and discard any unused portion.
Common side effects include nausea, vomiting, and headache. Injectable forms may cause swelling or redness at the injection site. Individuals using insulin should have glucagon readily available. Train family, friends, or caregivers on administration, as the person experiencing severe hypoglycemia cannot self-administer.